15 ago. 2014

Jacquelin Perry

Geoff Watts

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Full-size image (64K) Rancho Los Amigos National Rehabilitation Center
Orthopaedic surgeon and leading authority on gait analysis. She was born in Denver, CO, USA, on May 31, 1918, and died in Downey, CA, USA, on March 11, 2013, aged 94 years.
When orthopaedic surgeon Jacquelin Perry found herself obliged for health reasons to stop operating she followed the advice she was accustomed to give her patients: accommodate to your new reality. With a prior qualification in physical therapy and already interested in human movement, her own accommodation with reality was to set up a gait laboratory at Rancho Los Amigos National Rehabilitation Center in California. Perry established first a national and then an international reputation as one of the leading authorities on the biomechanics of walking and other forms of movement. In 1992 she wrote what is still a highly regarded textbook on gait analysis, and she continued working until the end of her life. Despite living with Parkinson's disease for 20 years and eventually requiring a wheelchair, she never gave in to her own loss of mobility. Neurologist Professor Helena Chui of the Keck School of Medicine at the University of Southern California worked with Perry for 10 years and knew her well for more than 30. “She was in the lab until the week before she passed away”, she says. “Jacquelin was a giant in her field.”
Although Perry had known from the age of 10 years that she wanted to be a doctor, this is not how her career began. With a degree in physical education she joined the US Army and trained as a physical therapist at the Walter Reed Hospital in Washington DC. It was another 5 years before she had the opportunity to study medicine. In 1950, with a medical degree from University of California, San Francisco, she moved into orthopaedics, becoming one of the first ten women to be certified by the American Board of Orthopaedic Surgery. In 1955, Perry joined Rancho Los Amigos, the rehabilitation hospital where she was to spend the rest of her career. In collaboration with a colleague, orthopaedic surgeon Dr Vernon Nickel, she designed a device known as the halo, a metal ring attached by four screws into the skull and used in conjunction with metal rods to immobilise the spine and neck of patients with polio who had recovered sufficiently to leave the iron lung used to maintain their respiration, and who needed support in an upright position.
It was in the late 1960s that Perry was forced to abandon surgery says Professor Mary Ann Keenan of the Department of Orthopaedic Surgery at the University of Pennsylvania. “She had a vascular abnormality at the base of her brain, and when she turned her head she would get severe vertigo. She coped well with this change. But then she was always very practical.” By focusing on gait analysis Perry was able to continue in orthopaedics, and also use her skills as a physical therapist. “She looked at everything from a functional perspective”, says Keenan. “It could be someone with very severe physical limitations or a high-performing professional athlete. She worked from one end of the spectrum to the other.” As Chui adds, “She made herself the supreme expert on what was wrong with someone's gait. She took it apart to understand it, and then set out to fix it.” Perry's thinking is still influential, notes Chui: “It's the gold standard for gait analysis.”
During the 1980s Perry was among the first to make a close study of what became known as the post-polio syndrome. This condition affects polio survivors years after their recovery from infection with the virus and is characterised by progressive muscle weakness and atrophy, fatigue, pain from joint degeneration, and skeletal deformities such as scoliosis. She guided their rehabilitation, all the time advising them, “Listen to your body and adopt a programme that avoids strain.”
“Most people who worked with her would tell you she was intimidating, and that's how I felt on first meeting her”, says Keenan. “She would challenge you with difficult questions. She could see the essence of problems and wanted to hear your reasoning.” Chui agrees, commenting that “She was tough love. People were afraid of her because she held them to such a high standard. But they loved her because they knew she had the same standard for herself.” And although Perry was not a golfer, Keenan adds, she could criticise your play: “She'd tell you what was wrong with your swing even though she'd never hit a golf ball. She understood movement. And if you did what she said you played better!”Post Polio Litaff, Association A.C _APPLAC Mexico

Casos de Polio salvaje oficialmente reportados al 11 de agosto de 2009







La noticia, por supuesto que es relevante, la adjudicación implica el reconocimiento del padecimiento en todos los países del mundo.Esperemos tomen las autoridades de cada país ciertamente tomen el tema con toda la seriedad y por supuesto se implementen las medidas conducentes para todas aquellas personas que hemos padecido la poliomielitis, hoy estámos sufriendo, o pueden sufrir, el Síndrome Post-Polio.

Total mundial de casos en 2009: 817 (comparado con 1008 para el mismo periodo en 2008)
Total en países endémicos: 601 (comparado con 948 para el mismo periodo en 2008)
Total en países no endémicos: 216 (comparado con 60 para el mismo periodo en 2008)
India: 184 casos (comparado con 355 para el mismo periodo en 2008), fecha de inicio de parálisis del caso más reciente: 24 Jul 2009
Pakistán: 31 casos (comparado con 27 para el mismo periodo en 2008), fecha de inicio de parálisis del caso más reciente: 23 Jul 2009
Chad: 13 casos (comparado con 9 para el mismo periodo en 2008), fecha de inicio de parálisis del caso más reciente: 15 Jul 2009
Nigeria: 372 casos (comparado con 552 para el mismo periodo en 2008), fecha de inicio de parálisis del caso más reciente: 12 Jul 2009
Angola: 18 casos (comparado con 23 para el mismo periodo en 2008), fecha de inicio de parálisis del caso más reciente: 08 Jul 2009
Guinea: 15 casos (comparado con 0 para el mismo periodo en 2008), fecha de inicio de parálisis del caso más reciente: 06 Jul 2009
Afganistán: 14 casos (comparado con 14 para el mismo periodo en 2008), fecha de inicio de parálisis del caso más reciente: 05 Jul 2009
Liberia: 7 casos (comparado con 0 para el mismo periodo en 2008), fecha de inicio de parálisis del caso más reciente: 29 Jun 2009
Côte d'Ivoire (Costa de Marfil): 23 cases (comparado con 0 para el mismo periodo en 2008), fecha de inicio de parálisis del caso más reciente: 26 Jun 2009
Rep. Democrática del Congo: 3 casos (comparado con 3 para el mismo periodo en 2008), fecha de inicio de parálisis del caso más reciente: 24 Jun 2009
Rep. de África Central: 14 casos (comparado con 1 para el mismo periodo en 2008), fecha de inicio de parálisis del caso más reciente: 22 Jun 2009
Kenia: 17 casos (comparado con 0 para el mismo periodo en 2008), fecha de inicio de parálisis del caso más reciente: 30 May 2009
Níger: 15 casos (comparado con 13 para el mismo periodo en 2008), fecha de inicio de parálisis del caso más reciente: 28 May 2009
Sudán: 44 casos (comparado con 3 para el mismo periodo en 2008), fecha de inicio de parálisis del caso más reciente: 28 May 2009
Burkina Faso: 12 casos (comparado con 1 para el mismo periodo en 2008), fecha de inicio de parálisis del caso más reciente: 20 May 2009
Uganda: 8 casos (comparado con 0 para el mismo periodo en 2008), fecha de inicio de parálisis del caso más reciente: 10 May 2009
Benin: 20 casos (comparado con 1 para el mismo periodo en 2008), fecha de inicio de parálisis del caso más reciente: 19 abril 2009
Togo: 6 casos (comparado con 0 para el mismo periodo en 2008), fecha de inicio de parálisis del caso más reciente: 28 Mar 2009
Mali: 1 caso (comparado con 0 para el mismo periodo en 2008), fecha de inicio de parálisis del caso más reciente: 04 Jan 2009
Gana: 0 caso (comparado con 0 para el mismo periodo en 2008), fecha de inicio de parálisis del caso más reciente: 08 Nov 2008
Nepal: 0 caso (comparado con 4 para el mismo periodo en 2008), fecha de inicio de parálisis del caso más reciente: 15 Oct 2008
Etiopía: 0 caso (comparado con 2 para el mismo periodo en 2008), fecha de inicio de parálisis del caso más reciente: 27 abril 2008
Total mundial de casos en 2008: 1651
Total en países endémicos: 1505
Total en países no endémicos: 146


Boletín Semanal de Polio 
Proyecto de Inmunización Integral de la Familia
Área de Salud Familiar y Comunitaria Vol. 24, No. 16
Boletín semanal para la semana que termina l 25 de abril de 2009
AMERICAS LA POLIOMIELITIS HA SIDO ERRADICADA DE LAS AMÉRICAS
El último caso con poliovirus salvaje fue detectado el 5 de septiembre de 1991, en Perú
V i g i l a n c i a d e l a P o l i o m i e l i t i s e n l a s A m é r i c a s
Cuadro No.1 Análisis de las muestras de heces de casos Ultimas 52 semanas (2008/18-2009/16)
SIN RESULTADOS AISLAMIENTO DE ENTEROVIRUS
PUNTOS DE CONTACTO
Señor Representante de la OPS/OMS en México
Oficina Sanitaria Panamericana
Apartado 10-880 y 37-473 (sin Cambio)
México
06600
DF
Sitio web de la oficina en el país postmaster@paho.org http://www.paho.org/

What are the late effects of polio?

A Few Words about Definitions  (Source: Post-Polio Health International) 

Diagrams courtesy of
Post-Polio Health International
Technically, post-polio syndrome is NOT the same condition as post-polio sequelae / the late effects of polio. Post-polio syndrome is usually considered a specific NEW condition. A diagnosis of exclusion is used to determine if a patient has post-polio syndrome. This means if a survivor of polio is found to have osteoarthritis, for example, that is what the diagnosis will be – osteoarthritis, not post-polio syndrome. Because of this, the number will be lower for post-polio syndrome than when the number is referring to post-polio sequelae or the late effects of polio.
Twenty-five to forty percent of polio survivors experience post-polio syndrome (depending on the study).
As many as seventy percent of polio survivors are said to have post-polio sequelae or the late effects of polio.
The Late Effects of Polio – The Paralytic versus Non-Paralytic Polio Debate . . .
“It should be absolutely understood that patients who were told that they had ‘non-paralytic’ polio did, in reality, have polio, which affected their anterior horn cells. Now, 30 to 40 years later, these patients are potentially subject to all of the vagaries and insults to the body that affect other persons with postpolio syndrome.”
A Clarification of “Nonparalytic” Polio
Johnson, Ernest W MD
American Journal of Physical Medicine, Vol. 79(1), Jan/Feb 2000
“Asserting that a history of paralytic polio is required for a history of PPS effectively, and incorrectly, says that no neurologic damage was done during acute nonparalytic polio.”
Late Functional Loss in Nonparalytic Polio
Falconer, Marcia PhD; Bollenbach, Edward MA
American Journal of Physical Medicine, Vol. 79(1), Jan/Feb 2000
“PPS must be considered in the differential diagnosis of individuals with unexplained fatigue and weakness … regardless of whether they report a prior history of paralytic polio”
Late Functional Loss in Nonparalytic Polio
Halstead, Lauro S MD; Silver, Julie K
American Journal of Physical Medicine, Vol. 79(1), Jan/Feb 2000
Managing the late effects of polio
Polio-experienced health professionals recommend a management plan that is designed specifically for the individual polio survivor. The plan may include a variety of recommendations including:
  • bracing to support weak muscles and/or over-used and stretched joints
  • use of walking sticks and crutches to relieve weight on weak limbs and to prevent falls
  • customized shoes to address unequal leg lengths, which can be the cause of back pain and requires extra energy to walk
  • use of wheelchairs or motorized scooters for long-distance
  • recommendation of weight loss
  • recommendation of specific select exercises to avoid disuse weakness and overuse weakness
  • use of a breathing machine at night to treat underventilation
Polio survivors can also help them themselves by ‘listening’ to their bodies and ‘pacing’ their activities. With time, survivors can learn when to stop before they become over fatigued. Many survivors report feeling better after adapting assistive devices and interspersing activities with brief rest periods. Read more in PPS Guidelines for people who have had polio. http://www.polioaustralia.org.au/what-are-the-late-effects/

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Enlaces

México Post Polio Una Vida Un Camino Una Experiencia
http://postpoliosinmex.blogspot.com/

Post Polio LITAFF A.C.

www.postpoliolitaff.org/
Postpoliolitaff.- Asociación Post Polio Litaff A.C Primera Organización oficial sobre Síndrome de Post Poliomielitis En México.


Polio y Efectos Secundarios SPP
http://polioyspp.blogspot.com/
- See more at: http://polioamigossinfronteras.blogspot.mx/#sthash.6PkHAkfM.dpuf

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